COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for coronavirus disease 2019 (COVID-19), continues to have a devastating impact on healthcare systems worldwide, and many questions remain unanswered. The effect of COVID-19 on the pregnant population is widely debated, and the unique risks in pregnancy have not yet been elucidated. What has been established, however, is the recommendation for healthcare workers to use personal protective equipment (PPE) for both contact and airborne precautions to prevent transmission of the pathogen—adding another barrier to care for vulnerable populations. We report a case of a young woman from Haiti during her first pregnancy, who was admitted to the antepartum service at 22 weeks of gestation with preterm premature rupture of membranes (PPROM) and remained admitted in isolation, though asymptomatic, for over six weeks due to persistent positive SARS-CoV-2 testing. Our case highlights the unique barriers to care that COVID-19 poses to antepartum patients, particularly in the setting of pregnant women with persistent positive testing.

Reported Effects of Coronavirus Disease Pandemic on Provision of Skilled Antenatal and Delivery Care Among Nurses and Midwives in Ibadan, Nigeria

“…This is similar to previous studies by Pant, et al 13 that many efforts have been made towards improving maternal health service utilization including information, education, and communication to raise awareness about the protection of mother and child during COVID-19, such that some countries have tried to open temporary birth centers, help hotlines, virtual consultation with obstetricians have been provided to women seeking maternal health care and that there is a consensus that utilization of maternal health services is essential as it reduces maternal and child mortality and improves the reproductive health of women. 90.1% of the respondents agreed that staffing issues and implementing safety protocols were the major challenges faced in the provision of maternity services during the pandemic, this is similar to a study done by Burgoyne et al, 14 that revealed that, with essential precautionary measures in place, obstetric healthcare providers may not be able to provide the highest quality care during the COVID-19 pandemic, client-provider interaction is severely hampered, and the time to get the care needed may be delayed as health workers try to protect themselves from the infection.…”

Maternal health care services utilization amidstCOVID-19 pandemic in West Shoa zone, central Ethiopia

“…Strained health care systems, disruptions in care, and redirected resources might result in non-pandemic-related maternal morbidity and mortality and reproductive health crisis which are particularly true for African countries including Ethiopia with low-resource health systems [ 6 , 8 ]. Obstetric healthcare providers may not be able to provide the highest quality care during the COVID-19 pandemic with essential precautions in place, client-provider communication is severely affected and the time to get the care needed may take longer as health workers try to protect themselves from the infection [ 9 ].…”

Proning in Pregnancies Complicated by Acute Respiratory Distress Syndrome. A Call to Action During the COVID-19 Pandemic.

“…Among the complexity of managing a pregnant intubated patient, COVID-19 adds additional challenges (26). With multiple treatment strategies going amiss (27), proning remains a well-proven intervention in ARDS and should be considered in pregnant women when indicated.…”